Healther Providers Data Logo

24D2185909 CLIA NUMBER - GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #6686

Laboratory Demographics

CLIA Number: 24D2185909

Facility Name: GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #6686

Facility Address:
4528 GRAND AVENUE
DULUTH, MN
ZIP 55807
Get Directions

Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1093060725

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 24D2185909
LAB Type Pharmacy
Facility Name GRAND ST PAUL CVS, LLC DBA CVS/PHARMACY #6686
Street 4528 GRAND AVENUE
City DULUTH
State MN
ZIP 55807
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 6/11/2022
CertificateExpirationDate 6/10/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024